Residential College | false |
Status | 已發表Published |
Finding flaws in the spatial distribution of health workforce and its influential factors: An empirical analysis based on Chinese provincial panel data, 2010–2019 | |
Qian Bai1,2; Xinyu Ke1,2; Lieyu Huang3; Liming Liu4; Dongmei Xue1,2; Ying Bian1,2 | |
2022-12-14 | |
Source Publication | Frontiers in Public Health |
ISSN | 2296-2565 |
Volume | 10Pages:953695 |
Other Abstract | Background: The maldistributions of the health workforce showed great inconsistency when singly measured by population quantity or geographic area in China. Meanwhile, earlier studies mainly employed traditional econometric approaches to investigate determinants for the health workforce, which ignored spillover effects of influential factors on neighboring regions. Therefore, we aimed to analyze health workforce allocation in China from demographic and geographic perspectives simultaneously and then explore the spatial pattern and determinants for health workforce allocation taking account of the spillover effect. Methods: The health resource density index (HRDI) equals the geometric mean of health resources per 1,000 persons and per square kilometer. First, the HRDI of licensed physicians (HRDI_P) and registered nurses (HRDI_N) was calculated for descriptive analysis. Then, global and local Moran's I indices were employed to explore the spatial features and aggregation clusters of the health workforce. Finally, four types of independent variables were selected: supportive resources (bed density and government health expenditure), healthcare need (proportion of the elderly population), socioeconomic factors (urbanization rate and GDP per capita), and sociocultural factors (education expenditure per pupil and park green area per capita), and then the spatial panel econometric model was used to assess direct associations and intra-region spillover effects between independent variables and HRDI_P and HRDI_N. Results: Global Moran's I index of HRDI_P and HRDI_N increased from 0.2136 (P = 0.0070) to 0.2316 (P = 0.0050), and from 0.1645 (P = 0.0120) to 0.2022 (P = 0.0080), respectively. Local Moran's I suggested spatial aggregation clusters of HRDI_P and HRDI_N. For HRDI_P, bed density, government health expenditure, and GDP had significantly positive associations with local HRDI_P, while the proportion of the elderly population and education expenditure showed opposite spillover effects. More precisely, a 1% increase in the proportion of the elderly population would lead to a 0.4098% increase in HRDI_P of neighboring provinces, while a 1% increase in education expenditure leads to a 0.2688% decline in neighboring HRDI_P. For HRDI_N, the urbanization rate, bed density, and government health expenditure exerted significantly positive impacted local HRDI_N. In addition, the spillover effect was more evident in the urbanization rate, with a 1% increase in the urbanization rate relating to 0.9080% growth of HRDI_N of surrounding provinces. Negative spillover effects of education expenditure, government health expenditure, and elderly proportion were observed in neighboring HRDI_N. Conclusion: There were substantial spatial disparities in health workforce distribution in China; moreover, the health workforce showed positive spatial agglomeration with a strengthening tendency in the last decade. In addition, supportive resources, healthcare needs, and socioeconomic and sociocultural factors would affect the health labor configuration not only in a given province but also in its nearby provinces. |
Keyword | Health Workforce Spatial Distribution Influential Factor Spatial Econometric Model China |
DOI | 10.3389/fpubh.2022.953695 |
URL | View the original |
Indexed By | SCIE ; SSCI |
Language | 英語English |
WOS Research Area | Public ; Environmental & Occupational Health |
WOS Subject | Public, Environmental & Occupational Health |
WOS ID | WOS:000904774600001 |
Publisher | FRONTIERS MEDIA SA, AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE CH-1015, SWITZERLAND |
Scopus ID | 2-s2.0-85145052788 |
Fulltext Access | |
Citation statistics | |
Document Type | Journal article |
Collection | DEPARTMENT OF PUBLIC HEALTH AND MEDICINAL ADMINISTRATION Institute of Chinese Medical Sciences THE STATE KEY LABORATORY OF QUALITY RESEARCH IN CHINESE MEDICINE (UNIVERSITY OF MACAU) |
Corresponding Author | Ying Bian |
Affiliation | 1.State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau, China 2.2Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macau, China 3.Office of Policy and Planning Research, Chinese Center for Disease Control and Prevention, Beijing, China 4.School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China |
First Author Affilication | Institute of Chinese Medical Sciences; Faculty of Health Sciences |
Corresponding Author Affilication | Institute of Chinese Medical Sciences; Faculty of Health Sciences |
Recommended Citation GB/T 7714 | Qian Bai,Xinyu Ke,Lieyu Huang,et al. Finding flaws in the spatial distribution of health workforce and its influential factors: An empirical analysis based on Chinese provincial panel data, 2010–2019[J]. Frontiers in Public Health, 2022, 10, 953695. |
APA | Qian Bai., Xinyu Ke., Lieyu Huang., Liming Liu., Dongmei Xue., & Ying Bian (2022). Finding flaws in the spatial distribution of health workforce and its influential factors: An empirical analysis based on Chinese provincial panel data, 2010–2019. Frontiers in Public Health, 10, 953695. |
MLA | Qian Bai,et al."Finding flaws in the spatial distribution of health workforce and its influential factors: An empirical analysis based on Chinese provincial panel data, 2010–2019".Frontiers in Public Health 10(2022):953695. |
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